Interventionsprogramme bei psychischen Belastungen von Kindern von Militärangehörigen in den USA
Ergebnisse eines systematischen Literaturreviews hinsichtlich der Übertragbarkeit auf Deutschland
Abstract
Zusammenfassung. Kinder von Eltern, die beruflich erhöhten Risiken ausgesetzt sind, haben auch selbst ein erhöhtes Risiko, psychische Probleme auszubilden. Ziel der vorliegenden systematischen Literaturübersicht war es, Interventionsprogramme für Kinder von Militärangehörigen in den USA hinsichtlich ihrer Evidenz, der Art und der Adressatinnen und Adressaten sowie ihrer Übertragbarkeit auf die Situation Bundeswehrangehöriger zu überprüfen. In die aktuelle Übersicht wurden 27 Programme eingeschlossen. Dabei handelte es sich um Programme zu spezifischen Präventionsansätzen, die direkt oder indirekt auf die Bedürfnisse der Kinder im Rahmen des sogenannten „emotional cycle of deployment“ (Vorbereitung, Trennungsphase, Rückkehrphase) zugeschnitten waren. Inhaltlich wurden folgende Programmschwerpunkte identifiziert: allgemeine und spezifische (Erziehungs-)Fähigkeiten der Eltern, Stressreaktionen, Bewältigungsstrategien sowie Zusammengehörigkeitsgefühl. Die Prävention erfolgte jeweils zu 40 % durch universelle oder selektive Maßnahmen und zu 20 % indiziert. Erste positive Effekte ließen sich für neun Interventionen im Rahmen von randomisiert kontrollierten oder nichtexperimentellen Studien finden. Die Qualität der Evaluation schwankte beträchtlich, sodass insgesamt die Evidenz der Programme begrenzt ist. Hinsichtlich der Übertragbarkeit lässt sich schlussfolgern, dass es sinnvoll ist, einzelne Elemente der Programme, abgestimmt auf das deutsche Gesundheits- und Sozialsystem, zu integrieren. Dies betrifft vor allem spezifische Inhalte aufgrund der Lebenssituation der Familien und systematische Screenings hinsichtlich möglicher Belastungen und psychischer Störungen. Darüber hinaus zeigte sich, dass weniger der Aufbau von Parallelstrukturen notwendig ist als die Qualifikation der Mitarbeiter in den Regelsystemen.
Abstract. Military personnel who have been deployed in war zones or other unstable regions are at an increased risk to develop mental health disorders, including posttraumatic stress disorder. Likewise, their children are at high risk to develop mental health problems as well as emotional and behavioral difficulties. Most research on prevalence of mental health problems as well as on interventions within this group was conducted in the USA. In Germany, no systematic intervention for children of military members focusing on their experiences of deployment exist. The systematic literature review aimed to analyze existing intervention programs in the USA, in particular for children of military members regarding evidence, type and addressed target group (parents, children, both). Compared to the social welfare and health care systems in the USA, the German systems are different. Hence, a second aim was to examine the transferability of these programs to the specific needs of children of German military members (Bundeswehr). 27 intervention programs could be included in the review. Programs, directly or indirectly, are addressing the needs of children of a deployed parent. They are usually focusing on the „emotional cycle of deployment“ (phase of preparation of deployment, separation phase of deployment and the return of the deployed parent). The programs mainly focused on parenting skills, family reactions to stress, coping strategies of families, and the feeling of coherence within the family. Only 20 % of the interventions could be assigned to the type of indicated prevention. Nine interventions have shown positive effects (either in RCT or non-experimental designs). Several elements of the programs are transferable to the German situation of children of military members. In particular, contents which address the specific situation of families with a military member are desperately needed in Germany. Transferability is limited by the non-comparability of health care and social welfare systems in the USA and in Germany.
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